Vitreoretinal Surgery

What is retina?

Retina is a very delicate film at the back of the eye. The image is formed here and then transmitted to brain via the optic nerve. The vitreous jelly lies just in front of the retina.

What are the types of retina surgeries?

Retina surgeries mainly are of two types, Vitrectomy and Scleral buckle.

Scleral Buckle is the procedure carried out in select cases of retinal detachment   in which a silicon band is fixed under the eye muscles on the white of the eye

Vitrectomy is a surgical procedure in which we remove the jelly (vitreous) of the eye for treatment of various retinal conditions. Vitrectomy is preferred for various retinal anomalies such as vitreous hemorrhage, retinal detachment, Epiretinal membrane, macular hole etc.

Is the surgery sutrureless?

Scleral buckling needs suturing whereas in vitrectomy we use 23/25-gauge system to ensure that wound size is small & most of the times surgery can be performed without sutures.

Along with vitrectomy additional procedures/ surgery are often needed?

• Sometimes, due to complex nature of retinal condition, there can be variation in the surgical procedure or a combination of various procedures maybe done. After removing the jelly (vitreous) surgeon may perform additional procedure(s) such as scleral buckling, membrane peeling, and laser/cryo, inject gas/ oil or perform cataract removal.
• In case silicon oil is used, a silicon oil removal surgery is performed after 3-6 months of first surgery depending on condition of retina.

 

What about the vision improvement do all patients see well?

• Visual recovery is an often-slow process. Although Anatomical success in modern day retinal surgeries has improved, the visual outcome depends on various factors other than just anatomical results & it may not be possible to predict beforehand.

Do we need to repeat retina surgery?

• If the existing retinal problem is not resolved after first surgery, re-surgery might be needed.
• Sometimes, the retinal problems can reoccur. Such as, retinal detachment or bleeding etc. at such times the surgery needs to be repeated.
• After use of silicon oil in the first surgery, a silicon oil removal surgery is performed at a later date.

What are the Newer advances in retinal surgery?

• Additional technology such as intraoperative OCT is useful to scan the retina during surgery to allow experts to see condition of retina on table.
• The digital 3D Artevo microscope enhances the retinal view digitally to enable surgeon to perform complex procedures.

What are the complications of retinal surgery?

Recurrence of retinal detachment, bleeding, infection, eye may shrink and turn white (Phthisis), cataract, glaucoma, floaters, glare, haloes, watering, itching, light sensitivity, thick glasses may be needed, loss of vision, loss of eye.